Migraine Triggers: Posture, Medication, and Symptoms

Migraine specific postures

Hello Doctor, around January 5th, I took Ritalin for the first time because I had an exam.
I had previously taken Adderall but hadn't taken it for over a year.
Shortly after taking Ritalin, I experienced palpitations for about 10 minutes, and then I started to have difficulty breathing.
The next day, as soon as I woke up, I had a migraine (on the right side), which only hurt when I bent down to get up; otherwise, it wasn't too painful.
Additionally, it seems like I have some blockage in my right ear, which hurts when I touch it.
The weather has been colder lately since I'm in Canada, and I'm wondering if these factors are related.

I had an MRI of my brain about two years ago due to stress while traveling abroad, which caused dizziness.
The doctor found no issues.
However, I have been experiencing some strange sensations in my body, such as abdominal pain (I had a colonoscopy, which was normal).
Should I see a doctor? It's not convenient for me to seek medical care while I'm abroad.
Thank you, Doctor.
I hope you can help me with my questions!

Hanhe, 10~19 year old female. Ask Date: 2019/01/09

Dr. Jiang Junyi reply Neurology

Hello, Ritalin is a mild to moderate central nervous system stimulant.
Its mechanism of action in the human body is not fully understood, but the stimulating effect is believed to occur through the inhibition of dopamine reuptake in the striatum without inducing dopamine release, which can lead to a state of mental stimulation.
The drug has a half-life of approximately 3-4 hours.
The recommended starting dose is 10 mg.
Dose adjustments can be made based on observed tolerance and therapeutic effects, increasing by 10 mg weekly until a maximum daily dose of 40 mg is reached.
Taking a high dose suddenly may result in significant side effects.
Common side effects include headache, nausea, decreased appetite, and insomnia.
It is advisable to consult a neurologist or psychiatrist for evaluation and treatment.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Hospital cares about you.

Reply Date: 2019/01/09

More Info

Understanding migraine triggers is crucial for managing this often debilitating condition. Migraines can be influenced by a variety of factors, including posture, medication, and individual symptoms. In your case, it seems that several elements may be contributing to your recent migraine episodes.

Firstly, let's discuss posture. Poor posture can lead to tension in the neck and shoulders, which may trigger migraines. If you are studying or sitting for long periods, especially in a position that strains your neck, this could be a contributing factor. When you mentioned that the pain occurs when bending down or getting up, it suggests that changes in posture might be playing a role in your headaches. Maintaining good ergonomic practices, such as using a supportive chair and keeping your screen at eye level, can help alleviate some of this tension.

Next, medication is a significant factor in migraine management. You mentioned taking Ritalin (methylphenidate) for the first time in over a year. Ritalin is a stimulant medication often used to treat attention deficit hyperactivity disorder (ADHD). While it can be effective for managing ADHD symptoms, it can also have side effects, including increased heart rate and anxiety, which you experienced as palpitations and shortness of breath. These side effects can potentially trigger migraines in susceptible individuals. If you have a history of migraines, it's essential to discuss any new medications with your healthcare provider, as they may have alternative options that are less likely to trigger headaches.

You also noted that you experienced a migraine after feeling stressed about an exam. Stress is a well-known migraine trigger. The combination of stress, changes in medication, and possibly poor posture could create a perfect storm for migraine onset. Additionally, you mentioned that the weather has been colder, which can also be a trigger for some individuals. Cold weather can lead to changes in barometric pressure, which has been linked to migraine attacks in some studies.

Regarding your ear pain and the sensation of blockage, it’s worth noting that sinus issues can also contribute to headaches. If you have allergies or sinus congestion, this could lead to referred pain in the head and neck, exacerbating your migraine symptoms. The right ear pain you described could be related to tension or even an ear infection, especially if you feel pressure or discomfort when touching it.

Given your history of migraines and the recent changes in your symptoms, it would be advisable to consult a healthcare professional, even if it’s challenging while you’re abroad. If you are unable to see a doctor in person, consider telehealth options, which have become increasingly available. A healthcare provider can assess your symptoms more thoroughly, review your medication regimen, and possibly recommend adjustments or additional treatments to help manage your migraines.

In summary, your migraines may be influenced by a combination of factors, including posture, recent medication changes, stress, and environmental conditions. Monitoring these triggers and seeking medical advice when necessary can help you manage your symptoms more effectively. Remember to take care of your overall health, stay hydrated, and maintain a balanced diet, as these factors can also play a role in migraine prevention.

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